COVID-19’s Effect on Pediatric Oral Health

By Lexi Marino January 19, 2021

In this episode, we caught up with Dr. Emilie McClellan, DDS and owner of Tooth Story Dental to get the inside scoop on how children and their parents are perceiving the dentist in the COVID-19 era.

Watch this video to learn the following:

  • How children are perceiving increased PPE in the dental office
  • Handling dental team stress and building comradery
  • Which types of dental technology help teams feel safe

Rolando Mia, from Zyris, is the host of our series, Dental Voice. In this show, we focus on the latest news, topics, and conversations happening in dentistry and assess differing views across the nation. In Season 2, we’re focused on, “What’s Working and What’s Not”, where we’re debunking myths by assessing trial and error since the start of Covid-19.


Rolando Mia: Hey, everybody, Welcome to Dental Voice, season two with Zyris. My name is Rolando Mia, and I’m here with Dr. Emilie McClellan. Now the purpose of Dental Voice is to hear directly from clinicians and the experiences that they’re having, because we had a discussion five months ago with Dr. Emilie as we were coming into COVID-19. I’m especially excited to hear how it’s going and have her share with us. I think that’s Dr. Emilie. Share with us, what’s going on? Good afternoon. This is the end of your day. How are you doing?

Dr. Emilie McClellan: Hello, I’m good. I’m so comfortable, you know been wearing this I was really gear up for five months and things are great. Great.

Rolando Mia: All right. So are you done for the day?

Dr. Emilie McClellan: I’m done for the day. Yes. We just saw the patient at about 30 minutes ago and we are done for the day and staff’s cleaned up and gone home.

Rolando Mia: So could you explain to me everything that you have on, and then you can take off the PPE and explain how this is how this is helping.

How Children Are Perceiving PPE

Dr. Emilie McClellan: Sure, you know, I just see kids and so seeing kids dressed like this, as opposed to six months ago has been a little different. So when our little kiddos come in, I try to explain what I’m doing and that they’re pretty familiar with gloves, but I say, you know, I’m wearing gloves today because I want to have really clean hands when looking at your teeth. So they understand that pretty well. And then I say, I have this weird hat on this weird hat I have I said, I wear this so that I can see your beautiful face and I don’t have any germs on coming from me. And so that is that part.

And then, they’re pretty used to seeing me in my loupes, but, I wear those usually all the time. And most kids are used to seeing a mask now, but to go… to see them right away with the mask on, most kids are wearing masks in any way, but they kind of get that. And they pretty much understand that.

I say, “You know, the reason I’m wearing my mask is because, well, first of all, my favorite color is pink.” No but I say, because, we have the virus now. So be really careful. And so most kids understand that as well. I think the thing we always have to remember though, is that these kids may not be able to read our mouths so make sure we’re speaking clearly so they can hear us, underneath everything.

So my clothes are clean when I go home to my kids and so they kind of like, “Why you wearing that big night gown?” Well because every size that is my size is out of stock. Now it’s hard to find things, but yeah, so that’s kind of how we explain why we’re dressed the way we are to our little patients.

Rolando Mia: Oh, that is so cool. Oh, there you are.

So how do you explain or you also take time or with regard to the parents and all that type of stuff, how is that going?

Dr. Emilie McClellan: I think most parents kind of get it. We walk out to the vehicle with the therapy dog and we’re dressed that way. And so we also had our video before we went back and parents and things like that. So most parents haven’t asked, they’re kind of used to it, but they kind of appreciate all the extra precautions we’re taking. So that’s good.

Rolando Mia: That’s so cool. When we’ve last talked, literally, you’d only just started seeing patients for just a couple of days. So it was absolutely new and you had done all the preparation and you’d done all of the planning and you put things together. You mentioned that you talked to your team, did every one of your teammates come back after the break and are they still with you?

Not Nervous Anymore Practicing During COVID-19

Dr. Emilie McClellan: They all came back. They all came back very enthusiastically and ready to go. I even hired two additional people, so our team has grown and then wonderful.

Rolando Mia: Oh, that’s so cool. There’s been a lot of talk about the teams feeling uncomfortable about coming back and the exposure and the potential for infection. Are you, are you sensing any kind of… Even a little bit of anxiety around that anymore? Or is it?

Dr. Emilie McClellan: No. Not anymore. I mean, I think we look at the numbers. There hasn’t been a lot of COVID cases coming into dental offices. We know how to do infection control. We’re trained in that, like a staff’s trained in that and we just added a couple more layers and I think we were so confident in what we’re doing. We’re so confident how we do it.

We haven’t had a single COVID case here, but we’re so thankful for that. And so, no my staff has… I mean, coming back, yes. You know, there’s all the talk dental is dangerous. And we were a little nervous, but I mean we’re not anymore. We’re just thrilled that we’re working again and thrilled to see our kiddos again. So it’s been good.

Rolando Mia: So what’s the… Share with me, what’s the experience of your kids coming back? What are some of the things that they’re sharing with you? What are some of the comments that they’re giving you about it and everything what’s that all like?

Dr. Emilie McClellan: Well, I think like the biggest thing they’re disappointed in is that they don’t get to play the toys in the games anymore because we have no more waiting room. We put the toys away, the games away. And so it’s, it’s a lot more of, we’re just going to visit and chat and maybe watch a movie that’s on the TV above them.

And so that’s kinda been one thing that they have that they have kind of missed. A lot of kids also miss their friends and they’ll talk about missing their friends. Cause they can’t see their friends or go on vacations, things of that nature. Overall, like kids are happy to be out in the battle, but I think getting out of the house.

Rolando Mia: Do you get sense that the children recognize or have the same kind of… Whatever you want. Fear I’m going to use, of being infected that the adults have or are they kind of just, do they not really understand what’s going on with regard to everything in the world today? What’s your experience with them around that?

Dr. Emilie McClellan: I would say like, our practice is generally focused on pretty young kids, like eight and under. And so I would say most of our kids don’t really have those anxieties, a few teams that we’ve seen have had those anxieties and concerns have asked certain questions, like making sure we have a mask to wash your hands. But for the most part, I think kids are just so easy going.

They just kind of go with the flow and they’re like, “Okay, I have to wear a mask. Okay. Am going to get the COVID tests,” they just kind of go with it. And I was kind of nervous coming back that kids were going to be scared of us and all that gear up and I just think kids are just so awesome. They just roll with it. I wish us adults could be more like that, but yeah, they have been good.

Rolando Mia: And no issue. That’s so cool. So the process how have they been with regard to the having to wait outside and what’s the reaction to having your therapy? What’s your therapy, dog’s name?

Dr. Emilie McClellan: Cal.

Rolando Mia: How do they like that experience with Cal?

Dr. Emilie McClellan: Oh, they love it. They love it. And we kind of make it fun with like drawing hopscotch on the sidewalks as kids can come in, doing things like that. But it hasn’t been too bad with a little bit of changes they’re waiting outside or waiting with mom and dad in the car for a minute. When we try to just be really efficient and timely in our appointments in a minute and get them out on time. So there’s not a whole lot of waiting that can, kind of increase that anxiety and stuff.

Increases in Oral Decay

Rolando Mia: So that’s cool. I love the fact that the kids haven’t been freaked out your entire team is back. You’ve even added a couple of members, so you can serve and take care of folks that you’re taking so much care. Let me ask you this, Are you experiencing a lot of, there’s been a lot of talk about how… Because people, kids, adults haven’t been back for so long oral health is starting to become an issue. Are you seeing that with the kids and with regard to things like decay and just compromise?

Dr. Emilie McClellan: Oh yes. It’s kind of funny. There is one teenager, we asked him like, “Dude, why don’t you brush teeth?” I have to wear a mask anyways, you know? And I’m like, “Oh my gosh, no, no, no.” So yeah, we have seen probably more poor oral hygiene habits. I think also being in a routine with school and things like that. Kids are kind of falling out of routine and parents have fallen out of routine. Plus snacks are kind of more frequent maybe at home than they would be if we were in routine or at school, maybe a little bit, Rolando is that you.

Rolando Mia: I go through a five pound bag of trail mix in like three days. It’s so horrible.

Dr. Emilie McClellan: Oh, I know. Right. It’s … But yeah, but in all truth, like our decay rate has really gone up, we’re community. And so we get a lot of kids that move in and a lot of kids were maybe slated or had scheduled appointments where they were going to be in those got canceled. Now they’re moving here and having a hard time getting in. And so we’ve even seen a few new patients this week that haven’t been seen in quite a while and were supposed to get treated, but then move and couldn’t get and so I would say our decay rates really high right now, the oral hygiene is.

But where we really want to encourage people get into the dentist, like make sure that your kids are healthy, make sure that they’re brushing their teeth. Let’s keep the snacks a bay. Don’t be afraid to come. Like we’re here, we’re ready. We have all precaution set We want to make sure that your teeth are healthy.

Rolando Mia: Oh wow. That’s, that’s amazing. When you think about it with the adults, the added stress, clenching, cracked teeth, we’ve heard about that. Having to wear the mask, the questions about working and all that. And then, you know, it kind of translates. It’s interesting that it’s translating down to the kids.

So I think… when we’ve last talked, probably the biggest… It continues to be a pretty huge issue. Is this the transmission of this disease of COVID. And that it’s definitely an aerosols or definitely people are saying that it is how are you dealing? We were talking about HVAC systems, vacuum, all that. How is it with aerosols with you?

Leveling Up Infection Control Protocols

Dr. Emilie McClellan: Well, we were doing the social distancing of course. We use Isolite® in just about every single procedure. I mean, it’s not a question we put it in and then we also have the HVAC with it. So I feel we’re doing everything. Yeah. Everything we can. So we even take Isodry® to the OR in which is really fun and very helpful. And it’s been a great tool for us during this time. Yeah.

Rolando Mia: What, what kind of additional procedures with regard to surfaces have you put in place? what does that look like for your practice now?

Dr. Emilie McClellan: Yes. So we don’t set up early anymore. We didn’t do that a whole lot anyway before, but definitely minimizing as much extra stuff around as possible. Like we used to have books and cute things around and now obviously we’ve taken those down. We wipe and let things stay wet for a little longer than before. And of course have the COVID sign in all those things and just taking a couple extra minutes between patients is, is just worth it, I think for our peace of mind and what not. So, yeah.

Rolando Mia: Wow. And as far as you kind of mentioned it, what is the experience that your team is having, having all the extra garb and the face mask and the shield and having to all that, what’s your experience around that?

Dr. Emilie McClellan: We go out to the vehicles and meet the parent and the child. We wear all of the PPE. It’s one of those things, like it’s exhausting. We don’t like it, but we know we have to do it and we’re just going to do it and keep a happy face about it. So, yeah.

Rolando Mia: So it’s really comfortable. I think that’s what you said when we first got on, right. Oh, wow. So I’m curious, there’s been a lot of discussion. There’s been a lot of talk. Just the recent live stream that we had with Dr. Mark Hyman. He had mentioned that there was a study putting out that practices are opening, which is a good thing, but the number of patients has decreased or actually heard that there are some practices out there that haven’t opened up at all. Are you, are you seeing that, are you experiencing any of that with yours or in your area?

Dr. Emilie McClellan: I haven’t seen that in my local area. No, we’re pretty small community. About 50,000 people and all offices have reopened, I would say most of us are doing well. We haven’t seen that here. Thankfully, no.

Rolando Mia: And, and how’s your practice doing? Are you seeing your patients come back? Are you seeing the same, the level of engagement that you had prior to all of this?

Dr. Emilie McClellan: Well, we had a very busy summer, with just rescheduling people and getting kids in before school. We added more hours because we couldn’t see as many at once. And so we had good numbers, but now we’re coming up to that six months from when we were all closed, with quarantine, so now I’m looking at my end of September, October schedule and things are a little lean.

So we kind of knew that coming in, that there weren’t appointments being made for those six month recalls back then. And so we’ve tried to get a little bit creative with our scheduling to kind of make sure the numbers are staying up. We are encouraging patients to call, new patients that are in town. Running some Facebook ads and campaigns and ‘Hey, come in and let’s get your teeth checked.’ Let’s get these kids’ teeth checked. So we had a great summer, but we’re starting to kind of go down a little bit here in the next few weeks.

Encourage Families to See Their Dentist Again

Rolando Mia: Oh, wow. Do you think it’s because people are still kind of staying away because they’re trying to hedge your bets with regard to whether they should go or not? Or do you think that it’s just a, it’s a function of kind of everything that’s going on?

Dr. Emilie McClellan: I think it’s both. I think school starting, I think there’s more like more like, oh my gosh, we’re going to be exposed more because some kids are going to school. Some kids aren’t. There’s colleges are starting up, we’re in a college town. I think people are being a little more careful about how much going up they’re doing. Just because of all those extra activities that are going around.

And then, I think it was one of those things it’s kind of like, you kind of forget about, with everything else. So just really want to encourage our families to be sure you’re getting those teeth check those kiddos and getting them all ready to go, you know, for school why not.

Rolando Mia: Yeah. Well, regardless of everything, I love the fact that through this all, you’ve always maintained such a positive attitude. There’s an energy to you, which is just pretty cool. And I mean, how’s that, how are you feeling about it? Are you, are you hanging tough there? I mean,

Dr. Emilie McClellan: There are days that I’m not so tough. but for the most part we’re okay. I think we try to look at life and you’re like, that was really hard being closed. And I was so happy we be opened and I’m looking ahead and I’m like, “Geez, we’re not very busy. Are we gonna…” You kind of get these fears and you’re like, but you know, I’m gonna look at the bright side.

Here’s some more time I can spend on with my kids or here’s some more time I can work on in my website or getting staff training or try to look at it and not get too down on myself. I think we’re all kind of getting sick of being at home and being not traveling and those kinds of things. And I think everybody’s getting a little weary by just trying to maintain some bright spots here and there is so important for everyone.

Rolando Mia: And how has the connection with your team last time we spoke? The message you gave was they’re incredible. How’s that going?

Dr. Emilie McClellan: Our team is good. They’re such good friends. My girls go out a lot and with not being able to see family and friend they’ve kind of become their own family. We all kind of have our own family now. And so even on weekends, we’ll spend some time together maybe doing a barbecue or something ’cause we feel comfortable being together. And so our team is really strong and they’re great. Like they’re goofballs. I love goofballs.

They’re just goofballs. They know it. Yeah. But it’s, it’s good. The team, command is really good. I think we try to make sure that we have fun amid all the stress that we are having. We are laughing. If something gets stressful at work one of the girls will start singing a song like, you know, just, okay, here we go. Hey, let’s just be happy. Clap your hands. And we all want to glare at her. Like….

Rolando Mia: You shared with me that one of your teammates has a foster child. His name is Declan, isn’t it?

How’s he doing?

Being Flexible With Your Staff’s Personal Needs During COVID-19

Dr. Emilie McClellan: He’s awesome. I let my staff bring their babies to work. So we always have baby, a lot of friends of the baby here. And one of my girls worked so hard to become a foster mom. She just worked her tail off for six, seven months and finally got her license. We had a huge barbecue for her, she got her license and she kept waiting and waiting and waiting and waiting to get matched.

And a couple of weeks ago, one little baby that was here was going to daycare like, “Oh, baby’s leaving.” And then two days later she gets a call that she’s got an infant that matched with her. It’s just a week old. And so we are so blessed. We have a little baby at the office again. And he’s just a tiny couple of weeks old and it’s just been so much fun to have another one around.

Rolando Mia: Oh my goodness. And you know what’s so cool too is, well, first of all, it’s okay to have your team bring their babies to work…

But also the context of safety and that you feel comfortable enough that you’re willing to bring your baby in. And you know, the fact that you haven’t seen infection and you’re taking all the protocols, I mean, was that ever an issue when you were thinking about that?

Dr. Emilie McClellan: No. We have rules, you know, like nobody holds the baby with that stuff on. And the baby’s things are in a separate area by the girls at the front desk or they’re surrounded by the plexiglass. And, and so we get to hold baby before patients and after we change. So, as in the back of it, the hold baby, as often are the girls that are answering the Phone at the front. But yeah, we’re just careful, and there hasn’t been any issues we’ve been really blessed and it’s just been awesome.

Rolando Mia: That is so, it makes me feels so, I mean, it’s so Holy cow. That’s what is it? People don’t care how much, until they know how much you care. And it’s pretty cool. I mean, that’s so awesome. From a personal perspective and all that how do you see, if I were to ask you, because one of the things that everyone is looking at is the future of this and how to navigate that, what are some of the things that you’re personally putting in place to kind of get you through that? And what are things that you’re considering with regard to moving forward at all?

Dr. Emilie McClellan: Yeah, I think one thing I kind of wonder is, how long do we do the social distance and the mask and having our waiting room closed and no toys and those kinds of things. It’s just hard, Rolando. I think all of us. I mean, so many of us are just getting tired and frustrated and miss our friends, miss our families, we want to travel, we want to do things. And it’s just not as easy as it was. And so I know I personally struggle a little bit.

So taking walks is good exercising, trying to eat right. We’re doing zoom calls with friends like you, family that’s not here. and just trying to encourage those around us too. It’s hard. Like there are days that you just get mad and you get frustrated, it’s hard.

Rolando Mia: What advice would you give people in addition to that? What advice would you give people who are, who don’t have those kinds of things, or are really, really, really struggling right now? what would you tell those folks

Dr. Emilie McClellan: Probably, you know, reach out to someone and talk don’t stay isolated and these fears and things need to be talked about and there’s options for that, with mental health providers or your physician or whomever a friend, be sure you’re reaching out, make sure you’re talking to people. I know that even, I have a lot of great friends here, physicians and optometrists and just great girlfriends and we’ll just go the pool or we just sit together, and we’ll just hash it out.

Like, you know, you just get angry.. And then you feel better. You’re like, “okay, I got that off my chest and I can go home” and be a mom or whatever I need to do. And so I think just talking to your friends and just getting through it, it’s going to be okay. We’re going to get there. we’re going to get there. we’re resilient. we’ll get there and he’ll be okay someday.

Rolando Mia: That’s cool. And you have two kids too. How are they experiencing what’s their experience through all of this with you, you know, working and going through that and everything. How’s that going?

Dr. Emilie McClellan: They’re, so awesome. My kids are amazing. They got to stay home all summer with a nanny. I’m really fortunate that I could do that. They go to private school, so they’re in school now. And they kind of say, “Mom, why can’t we go to the pool?” Or why can’t we do this or that? And they say, “Oh, because of the virus.” We can’t do some of those fun things that we used to do, but we’re hanging in there. They miss their friends and their family that’s not close. But we try to just keep things as fun as we can at home and little kids they’re just take it, I guess, you know,

Rolando Mia: They just get, yeah. They get it and they feel it and they say, we’re going to go. So what have you changed in your practice? Has anything really dramatically changed other than the increase in cleaning up and all that type of stuff?

How Isolite® and Isodry® Help Speed Up Pediatric Procedures

Dr. Emilie McClellan: Well, we use the Isolite and Isodry a ton more than we ever have. I think we get a shipment almost weekly. I feel like that’s been a huge change for us. And, it’s made dentistry a little faster too, honestly, because it’s all there and goes, and you have the bite block, the isolation, the retraction, the section, the light it’s.

So dentistry is going a little faster there and we’re getting quick at it, and so that’s changed. Not a whole lot else has really changed. I mean, really we were starting to increase patient numbers per day again, I think we’re getting a little more comfortable and getting quicker. And so we’re doing that, but nothing else has really changed. No, still here.

Rolando Mia: Still they’re, still tracking through, still going. I’m happy to hear that your patients are coming. It’s so wonderful to hear that your patients, they’re not freaking out. Was there anything that you thought was going to happen that completely just didn’t happen?

Dr. Emilie McClellan: II thought we’d all get COVID, I did. I thought I did well when we first opened, they kept spilling, you know, the four of the top five, most dangerous professions were all dentistry. And I was thinking, we’re in a college town where we treat military children, you know, one of us, all of us, we’re going to get it. And I was just kind of taking like, “Okay, we’re going to get it.” And I thought that for sure would happen. and it hasn’t, you know? Yeah. I mean, it hasn’t, we have been healthy. We’ve been careful.

We haven’t been reckless. We’ve been careful, we’ve been doing our due diligence. I also thought that kids would be scared of the mask and all that stuff I was wearing. I thought kids would be really scared and I thought it’d be harder to treat and hard to make those relationships. But, yeah, it hasn’t been it’s been okay. I’ve been very pleased with that.

Rolando Mia: First of all, I so appreciate you taking the time. I mean, it’s the end of your day. You’re still there. I’m sure you’re exhausted. You’ve got so much going on and I love the fact that things continue to go through. Like we did last time. if I were to ask you to sum up again, the kind of the sentiment and what message would you like to give to your team, to your patients, to your community, to the folks around there who are listening to us around this? What is it that you’d like to let them know?

Dr. Emilie McClellan: Well, I have to always start with my team because my staff is the best. Literally they’re the best. I love my girls each and every one of them, they keep me going. They keep me positive. We keep each other going, thank you, girls. You have no idea how much I love you. Every single one of you. Thank you. For my community. Hang in there guys. I’m proud of our community.

We have been strong through this, just stick together and for my patients, please come, we’re doing everything we can to keep you guys safe and we wanna make sure your teeth are healthy and strong and where we’re ready for ya. And to my kiddos, I love you Tyler and Tag. Thank you for being the best kids in the world. Mama loves you.